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Dissertation

My dissertation research examines the application of HIV law in Michigan, particulary the felony disclosure statute that makes it illegal for HIV-positive people to have sex without first disclosing their HIV-positive status.

Below, you can find both short (150-word) and more substantial (1000-word) abstracts detailing my research questions, methods, and findings. Please don't hesitate to contact me directly to request additional information about my research.

150-Word Abstract:

In the state of Michigan, people infected with HIV are required by law to disclose their HIV-status to their partners before engaging in sexual contact – regardless of whether that contact poses a risk of transmission. Failure to do so is a felony, punishable by up to four years in prison. Despite scientific advances in treating and managing HIV disease, prosecutions for nondisclosure have continued unabated and appear to be on the rise. My dissertation explains this paradoxical trend by arguing that Michigan’s HIV disclosure law was not intended to control HIV as a virus but rather as a moral infection requiring interdiction and punishment. With recent moves in several states to expand the criminal code to punish other diseases such as hepatitis, my dissertation responds to the urgent need to understand not only how justice has been medicalized but also how particular health issues come to lend themselves to interdiction and punishment.

1000-Word Overview:

In the state of Michigan, people infected with HIV are required by law to disclose their HIV-status to their partners before engaging in sexual contact. Failure to do so is a felony, punishable by up to four years in prison. Like statutes in 32 states that specifically criminalize nondisclosure, Michigan’s law does not require that the sexual contact pose a risk of HIV transmission – a fact illustrated vividly during the 2009 proceedings against a dancer convicted for not disclosing her HIV-positive status to a client before his nose allegedly penetrated her vagina. Indeed, despite scientific advances in treating and managing HIV disease, prosecutions for nondisclosure have continued unabated and appear to be on the rise. My dissertation, From Sickness to Badness: Enforcing Michigan HIV Law as a Site of Social Control, explains this paradoxical trend by arguing that Michigan’s HIV disclosure law was not intended to control HIV as a virus but rather as a moral infection requiring interdiction and punishment.

By revealing how the criminal law has come to regulate HIV in Michigan, From Sickness to Badness turns the classic sociological approach to studying the social control of sickness – medicalization – on its head. While medicalization theories have helped explain how social phenomena come to be regulated by medicine, much less is known about the converse process of how medical phenomena come to be regulated by the criminal law, which I term the “criminalization of sickness.” To understand this social process, my dissertation tackles three interrelated questions. First, in an article recently published in Social Problems, I analyze how local health officials enforce the larger “health threat to others” statute, which includes the felony nondisclosure law but also confers upon public health authorities additional powers for controlling individuals they declare to be deviant. Based on interviews with officials in 14 of Michigan’s 17 jurisdictions for HIV, I argue that the techniques employed by some officials in order to identify potential “health threat” cases (such as STI testing and contact tracing) cannot actually reveal whether or not an individual told his partner that he or she was HIV-positive. Yet, health officials’ conflation of nondisclosure with other, perfectly legal deviant practices (e.g. condomless sex) suggests that their intent is not simply to control the spread of disease but also to regulate a population they perceive as deviant.

Second, in an article punished in Social Science & Medicine, I draw on archival data associated with 95% of all cases convicted under the felony statute between 1992 and 2010 to analyze how legal actors transform HIV into a criminal matter in a court of law. Drawing on more than 4,000 pages of trial court transcripts, I demonstrate that legal actors frame HIV as a death sentence and HIV-positive defendants as reckless killers – even in cases where the sexual contact alleged posed a low or no risk of transmission. By analyzing the rhetorical strategies employed by legal actors invested in putting HIV-positive defendants behind bars, I reveal how the medical phenomenon of HIV becomes transformed into a moral question in Michigan courtrooms. My analysis traces the persistence of these narratives throughout the nearly two-decade study period, culminating in a 2009 case involving a dancer convicted for allowing her client’s nose to penetrate her vagina without first disclosing her HIV-status. As such, I argue that Michigan’s HIV disclosure law is not driven by insights into medical science, but rather a desire to control and punish populations deemed deviant.

The third, final component examines whether certain groups are bearing the brunt of the disclosure law’s application. Building on the pioneering work of crime scholars who have shown associations between victim characteristics and criminal justice outcomes, I show that men who have sex with men were collectively less likely to have been convicted under the disclosure law than men who have sex with women. Although critics have charged that the HIV disclosure law is motivated by anti-gay bias, it is heterosexual black men and poor white women who bear the brunt of its application. These findings suggest that Michigan’s HIV disclosure law is not evenly applied and may do more to exacerbate inequality rather than to promote justice.

This research is important and timely in terms of its scholarly impact as well as its potential implications for legal and political practice. Theoretically, this project contributes to our understanding of the social control of sickness. In coining the concept of medicalization, medical sociologists have evidenced how medical authorities come to claim jurisdiction over particular forms of deviance – a process referred to as the transformation from “badness to sickness.” Yet, we know little about how phenomena conventionally understood as medical come to be controlled by other institutions and forms of authority. By analyzing how the criminal law has come to control and punish disease, my project turns the medicalization thesis on its head and breaks new ground in understanding the social control of sickness.

Finally, with recent moves in several states to expand HIV disclosure and exposure statutes to include additional disease such as hepatitis, it is clearly urgent to understand not only how justice has been medicalized but also how particular health issues come to lend themselves to interdiction and punishment. By showing how HIV comes to be morally framed as a legal problem in Michigan, this project raises larger questions about justice and medicine that have implications beyond Michigan and beyond HIV.